Tuesday, July 31, 2007

Nobel Biocare CEO under pressure over dispute with Swedish authorities - report

ZURICH (Thomson Financial) - Nobel Biocare AB chief executive Heliane Canepa has come under fire over allegations that the Swedish-Swiss dental implant maker has issued misleading statements regarding the safety of its NobelDirect and NobelPerfect implants, Swiss Sunday paper SonntagsZeitung reported.

The two implants have been linked with cases of bone loss in the past.

Both the Swedish stock market watchdog, as well as Sweden's Medical Product Agency (SMPA), allege that the company has deliberately misinterpreted SMPA statements and misinformed the public over the safety of its products, the newspaper said, citing information from Sweden.

The newspaper also claims that Canepa has lost the confidence of board president Rolf Soiron.

Shares of the dental implant maker came under pressure on Friday amid speculation that former Syngenta AG (nyse: SYT - news - people ) CFO Domenico Scala could replace Canepa at the helm of the company.

Dentoalveolar trauma in Glasgow: an audit of mechanism and injury.

Wright G, Bell A, McGlashan G, Vincent C, Welbury RR. Dent Traumatol 2007; 23(4): 226-31.
Correspondence: unavailable
Affiliation: Department of Paediatric Dentistry, Glasgow Dental Hospital and School, Glasgow, UK.
DOI: 10.1111/j.1600-9657.2006.00430.x What is this?
(Copyright © 2007, Blackwell Publishing)
Traumatic dental injuries in children often require multiple follow-up visits to the dentist and may have long-term consequences for the developing dentition. The aim of this audit was to examine age, gender, location, time of year, mechanism of injury and type of injury sustained in relation to dentoalveolar trauma in children attending the paediatric dental trauma clinic at Glasgow Dental Hospital from 2002 to 2004, and to compare our findings with data in the published literature. Males suffered 60% of all dental trauma, 79% of sporting injuries and 85% of assaults. The injuries in males were more severe, representing 65% of enamel dentine and pulp fractures, 100% of crown root fractures and 66% of crown root and pulp fractures. A peak for trauma was seen in the 8-11-year-old group (43%). The majority of injuries in the under four age group resulted from falls (87%). Taken as a whole, falls accounted for 49%, sports related injuries 18%, bicycle and scooter 13%, assault 7%, and road traffic accidents 1.5% of all injuries. They also accounted for a far higher percentage of intrusive luxations (67%). The largest proportion of injuries occurred during the summer months (33%). Sixty-four percent of children suffered trauma to more than one tooth. Fifty-eight percent of injuries involved the dental hard tissues and pulp and the majority of these (82%) were crown fractures. Most subjects (82%) suffered trauma to their periodontal tissues, (26% concussion or subluxation, 26% lateral luxation and 23% avulsion). Injuries to the supporting bone were uncommon. Sixty-six percent of all injuries occurred outdoors. Our findings were similar to a number of published studies, but in contrast to several others. More consistency is required in the collection and reporting of trauma data to be able to draw meaningful conclusions by comparison.

Language: Eng

Monday, July 30, 2007

Bacterial contamination of water in dental unit reservoirs.

Ann Agric Environ Med. 2007;14(1):137-40.

Szymanska J.

Department of Paedodontics, Medical University of Lublin, ul. Staszica 11, 20-018 Lublin, Poland; adpunctum@adres.pl.

The aim of this study was bacteriological assessment of water in dental unit reservoirs - concentration and composition of the aerobe and facultative anaerobe bacterial microflora. Reservoir water samples were taken from 25 units. Bacterial flora were determined with the plate culture method. Bacteria were identified with biochemical microtests: API 20E, API 20NE (bioMerieux, France) and GP2 MicroPlateTM (BIOLOG, USA). The concentration of total bacteria isolated from one site was 201,039 cfu/ml, on average; the minimum was 22,300 cfu/ml, and the maximum - 583,000 cfu/ml. The following bacteria were identified: Gram-negative bacteria - Brevundimonas vesicularis, Moraxella lacunata, Moraxella spp., Ralstonia pickettii, Sphingomonas paucimobilis, Stenotrophomonas maltophilia; Gram-positive cocci - Micrococcus luteus, Micrococcus lylae, Staphylococcus cohnii, Staphylococcus hominis ss novobiosepticus, Staphylococcus spp., Streptococcus spp.; actinomycetes - Streptomyces albus. The prevailing bacteria were: Ralstonia pickettii (96.46%), found in all the units. Sphingomonas paucimobilis (1.32%) and Brevundimonas vesicularis (1.07%) were the next most frequently occurring bacteria. Bacteria concentration in dental unit reservoirs reached excessive values, and the bacterial flora were composed of the bacteria characteristic for water supply systems, opportunistic pathogens, and bacteria of the oral cavity flora. Continuous microbiological monitoring of the DUWL water, including application of a disinfecting procedure, is necessary.

PMID: 17655191 [PubMed - in process]

Sunday, July 29, 2007

Oral Bacteria Linked to Uterine Infections and Preterm Birth

Oral Bacteria Linked to Uterine Infections and Preterm Birth

By Jeff Minerd, MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
April 06, 2006

Explain to patients that while suggestive, the study's findings do not support routine analysis of pregnant women's oral or vaginal flora to identify those who may be at risk for uterine infection.

CLEVELAND, April 6 - The first hard evidence has been uncovered that bacteria in the mouth may find their way to the uterus, causing uterine infections that can lead to preterm birth in pregnant women.

A newly discovered and as yet unnamed species of the bacterium genus Bergeyella was found in the mouth and amniotic fluid of a woman with a uterine infection who gave birth prematurely (24 weeks), reported microbiologist Yiping W. Han, Ph.D., of Case Western Reserve here.

However, the bacterium was not detected in a vaginal swab, as might be expected. The finding confirmed what some scientists have suspected, that intrauterine infections don't always "ascend" from the genital tract but can "descend" from the oral cavity, Dr. Han and colleagues said in the April issue of the Journal of Clinical Microbiology.

The study included 19 pregnant women undergoing transabdominal amniocentesis because of preterm labor or threatened preterm labor. Amniotic fluid, blood samples, vaginal swabs, and oral swabs were collected from each woman and analyzed for bacterial DNA via polymerase chain reaction (PCR) and nucleotide sequencing.

The species of Bergeyella was detected in the mouths of all 14 women tested, but in the amniotic fluid of only one patient.

This woman had been diagnosed with a uterine infection based on an elevated white blood cell count and a low glucose level in the amniotic fluid. She went into labor, induced because of the infection, and delivered her baby at 24 weeks' gestation. Subsequent analysis of her placenta revealed severe and diffused chorioamnionitis and fetal vasculitis involving the umbilical cord and chorionic plate, which was the presumed cause of her preterm labor.

"Intrauterine infection with Bergeyella has never been reported before. Where could the bacteria come from?" the investigators asked. Because the bacteria were not detected in the vaginal tract, the investigators hypothesized they were transmitted to the uterus from the mouth via the bloodstream.

The bacteria were not detected in the patient's blood, but they had likely been cleared from the blood by the immune system before they could be detected, Dr. Han said.

Although periodontal disease has been implicated in preterm birth, the patient showed no evidence of periodontal disease, the researchers noted.

"The study is an eye-opener," Dr. Han said, "It shows that oral bacteria can get into the uterus."

The study also suggested that more than the usual bacterial suspects may be responsible for uterine infection and resulting preterm birth, Dr. Han added. The usual suspects are known vaginal flora such as Ureaplasma urealyticum or Mycoplasma hominis. But Bergeyella, a little-known, rod-shaped, Gram-negative bacteria associated with dog and cat bite wounds, had not been thought to be an important component of the oral or vaginal flora.

One reason Bergeyella may have been overlooked previously is that it is difficult to grow in culture. As much as 60% to 70% of oral bacteria can not be detected by growing on culture. The current study detected Bergeyella because it used PCR amplification of bacterial DNA rather than traditional culturing techniques, Dr. Han said.

While suggestive, the study's findings do not yet support routine analysis of pregnant women's oral or vaginal flora to identify those who may be at risk for uterine infection, Dr. Han said.

"That is the question we want to ask now," she said. Her research is examining whether particular components or oral or vaginal flora are associated with increased risk for uterine infection or preterm birth.

The mother and baby from the study are healthy and doing well, Dr. Han said.

Primary source: Journal of Clinical Microbiology
Source reference:
Yiping Han et al. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. Journal of Clinical Microbiology 2006; 44:1475-1483.

Friday, July 27, 2007

Online Photo Editing

Here is a new site currently in Beta but it works quite well.

Picnik allows you to modify and edit your photos. When you are done you can directly upload the photographs to Flickr, Picasa or Facebook. You can also save them to your hard drive. This is not a full photoshop program but does lots of the things you would expect out of a photo editor.

Thursday, July 26, 2007

Self-reported dental and oral injuries in a population of adults aged 18–50 years

David Locker
Self-reported dental and oral injuries in a population of adults aged 18-50 years
Dental Traumatology (OnlineEarly Articles).

Few population-based studies of traumatic dental injury in adults have been undertaken. The objective of this study was to assess the prevalence and severity of injuries to the mouth and teeth among adults aged 18–50 years living in the Canadian province of Ontario. A telephone survey was undertaken based on random digit dialling and 2001 adults in the target age range were interviewed. Overall, 15.5% reported a history of injury to the mouth and teeth. Of these, one-third reported two or more episodes of injury. Males were more likely than females to report injury and to have experienced more than one injury. There was no association with age but a U-shaped relationship with education. When asked about the nature of the worst injury experienced, 85% with a history of trauma reported damage to the teeth and of these, 38.5% reported one or more teeth were chipped and 26.0% broke one or more teeth. One quarter (25.4%) reported avulsions and 6.5% reported luxations. Other types of injury were reported by 3.5%. Two-thirds of the injuries reported occurred before the age of 18 years and one-third after this age. One-fifth of those with tooth injuries had not been treated by a health professional. This was not associated with the nature of the damage that occurred; rather subjects from the lower educational groups were less likely than those from higher educational groups to have received treatment. There was a significant association between injuries to the mouth and teeth and injuries in other body locations. One-third of those reporting two or more episodes of the latter reported having experienced injuries to the mouth and teeth. The results of this self-report study indicate that dental trauma constitutes a significant health issue among adults and that a minority may be injury prone. Health promotion programmes to reduce the incidence of injury among lower socioeconomic groups are needed since these have high rates of injury and the lowest rate of receipt of treatment.

Wednesday, July 25, 2007

Reaction of children to dental injection with 27- or 30-gauge needles

Here is a topic that continually comes up on the Internet Dental Forum with both sides passionate about it. Most studies conclude there is no difference in pain perception based on needle size. This article confirms this but with a slight twist. My opinion is that needle size does not make a difference. Proper use of topical makes a bigger difference.

Reaction of children to dental injection with 27- or 30-gauge needles
International Journal of Paediatric Dentistry (OnlineEarly Articles).

Aim. The purpose of this study was to assess children's reaction while receiving dental local anaesthesia with a 27- and a 30-gauge needle and to record their sensation.

Methods. Ninety-five children (43 boys and 52 girls) participated in this study. A random crossover design was used so that each child served as his or her own control, receiving each treatment on the opposite sides of the same arch (right vs. left). Each patient received an injection either with a 27- or 30-gauge needle during the first visit and during the second visit with the other needle. Objective and subjective evaluation were performed.

Results. Children's reactions to maxillary buccal infiltration either with a 27- or 30-gauge needle were similar. Significantly more children cried while receiving mandibular block injection with a 27-gauge needle than they did when receiving the injection with a 30-gauge needle (P = 0.002). According to subjective evaluation, most children rated both injections as a positive, nonpainful experience.

Conclusions. Mandibular block is less unpleasant, and children cry less when administered with a 30-gauge needle than they do when it is delivered with a 27-gauge needle. No difference in crying during injection is observed when maxillary infiltration is provided with 27- or 30-gauge needles.

Tuesday, July 24, 2007

Comparative chemical study of MTA and portland cements.

Here is an interesting article, considering the cost of MTA. This article talks about composition only and is not an in vivo study.

Braz Dent J. 2007;18(1):3-7.
Oliveira MG, Xavier CB, Demarco FF, Pinheiro AL, Costa AT, Pozza DH.

Department of Surgery, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

Portland cement has been analyzed and compared to mineral trioxide aggregate (MTA) because of their chemical similarity. The possibility of using this material as a less expensive alternative to MTA in dental practice should be considered. In view of this, the present study compared the components of a Portland cement (Votoran(R)) to two commercial brands of MTA (Pro-Root™ and MTA-Angelus(R)). Twelve specimens of each material were fabricated and examined by scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) to obtain their percentage of chemical elements. The means of the chemical elements found in each material was compared by descriptive statistics. Bismuth was present only in MTA cements to provide radiopacity. In conclusion, the tested cements have similar components, which supports, as far as composition is concerned, the possible clinical use of Portland as an option to MTA.

Monday, July 23, 2007

Sunday, July 22, 2007

Effect of antiasthmatic medication on dental disease: Dental caries and periodontal disease

Shashikiran ND, Reddy V.V.S, Raju P Krishnam
Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, India

Journal of Indian Society of Pedodontics and Preventive Dentistry

Year : 2007 | Volume : 25 | Issue : 2 | Page : 65-68

The prevalence of asthma has been increasing since the 1980s. Asthma and tooth decay are the two major causes of school absenteeism. There are few studies present in the literature. The objectives of the present study were to know the severity of dental caries and periodontal problems in children before and after taking antiasthmatic medication. The present study was conducted on 105, six- to fourteen-year-old asthmatic children to determine the condition of their dental caries and their periodontal status before and after taking antiasthmatic medication, for a period of 1 year and these were matched with their controls. The results showed that salbutamol inhaler shows increased caries rate with high significance over other groups, which was followed by salbutamol tablets and beclamethasone inhaler respectively. It has been concluded that antiasthmatic medication has its effects on dental caries and periodontal disease and asthmatic patients are recommended to adopt more precautionary oral hygiene practices and keep their caries activity and periodontal health under constant check.

Saturday, July 21, 2007

Dental students’ attitude towards anti-smoking programmes: a study in Flanders, Belgium

J. Vanobbergen, P. Nuytens, M. van Herk, L. De Visschere (2007)
Dental students’ attitude towards anti-smoking programmes: a study in Flanders, Belgium
European Journal of Dental Education 11 (3), 177–183.


Objective: The aim of the study was to assess the dental students’ attitude towards tobacco cessation counselling in the dental setting and to explore the influence of knowledge, belief in effectiveness, smoking status, gender and curriculum.

Material and methods: The study group consisted of all undergraduate students from the 2002–2003 classes of the Ghent University (n = 96). A validated questionnaire was administered to all students involving four different sections: demographic characteristics, attitude related to tobacco cessation programmes in the dental setting, belief in their effectiveness and knowledge concerning tobacco health effects. Statistical analysis included simple univariate nonparametric tests for evaluating differences in attitude towards tobacco cessation programmes, belief in effectiveness of tobacco cessation programmes in the dental setting and knowledge of students concerning tobacco health effects by year of graduation, smoking status and gender. Multiple logistic regression was chosen to calculate adjusted odds ratios and 95% confidence intervals.

Results: Students view willingness to advise individual patients to quit using tobacco. Yet only 51.3% are willing to co-operate in anti-tobacco programmes at the community level, and the perception of students of the effectiveness of smoking cessation counselling in the dental setting is low. The variance of attitude towards tobacco cessation programmes was significantly affected by knowledge and the belief in effectiveness of tobacco cessation programmes in the dental setting. Better knowledge and belief in effectiveness of tobacco cessation counselling was associated with an increasing positive attitude towards tobacco cessation programmes expressed by an odds ratio of 3.12 (95% CI 1.00–9.67) and 1.17 (95% CI 1.00–1.37) respectively.

Conclusion: Belief in effectiveness and knowledge seem to influence the attitude of students towards tobacco cessation counselling.

Practice implications: Besides imparting knowledge, the attitude of newly graduated dentists could be improved by stressing the effectiveness of smoking cessation activities during lectures and integrated training modules in the undergraduate education.

Friday, July 20, 2007

More On Palm's Foleo

So after a nights sleep I have digested what I saw at the NYC Palm Foleo preview. My view of the device has changed. I can see myself owning one of these devices but not at the release. I think within 6 months there will be more software from both 3rd parties and the open source community.

The size of the device is perfect for my needs. See the photo of the Foleo next to a 15 inch Macbook. The keyboard did not feel uncomfortable. In fact the device feels solid and was quite comfortable to hold. You can even turn the device on its side and rotate the screen and hold it like a book!

The Opera web browser has limits and renders web pages OK. The Foleos were using WiFi. The Foleo will stream Flash audio but not video. There is a standard stereo headphone jack and an internal mono speaker. Video is coming. There is no media player currently included with the Foleo. No IM even from the web.

There is a USB port so you can connect a USB Mouse/Keyboard. I did inquire about a presentation mouse but got a reply that it might work. There should be plenty of room for storage. The device comes with 128MB of space with about 100MB user accessible. There is a CF slot under the battery and an SD slot. This along with a USB flash drive and you should not have to worry about storage. There is no printer support at this time but was told if companies (not Palm) write the drivers the USB port could be used.

One of the reasons I went to the preview was to ascertain if the device could be used for presentations. The Documents to Go software will do PowerPoint but will not do animations or transitions. When connected to the external VGA (you need to use a dongle) source the menu bar gets striped off. Workable but not something I would be doing most of my presentations on.

I asked why they did not use Open Office and got a very good response. The reason is that this device is supposed to be instant on and instant apps switching. Open Office will take time to load. Hopefully a port of Open Office will happen and then a full presentation can be done with transitions and animations at the small sacrifice of no instant app switching.

One other thing that would be very useful is a remote desktop or VNC client. This way I could work on my PC no matter where I am.

So overall I liked the Foleo and will keep a close eye on the applications available for it after the release. With the right software I can see me leaving the notebook home.

Thursday, July 19, 2007

Palm Foleo

I was at the Palm Foleo preview tonight in New York City. I was quite impressed with the Foleo. It needs some more applications but it may be in my future. More to come with additional pictures as I am sitting on the train heading back to New Jersey.


Smiles For Life: A National Oral Health Curriculum For Family Medicine (Alan Douglass MD)

Smiles for Life is a comprehensive oral health curriculum for physicians developed by the STFM Group on Oral Health. It is designed to be implemented in residencies or medical school pre-doctoral programs. The core curriculum is based on four PowerPoint modules covering core areas on oral health; Module 1: The relationship of oral and systemic health; Module 2: Child oral health; Module 3: Adult oral health; Module 4: Dental emergencies. Each module is designed to be presented in 50 minutes. Each slide is annotated with speaker notes and relevant references. Also included with the curriculum are a comprehensive set of educational objectives based on the ACGME competencies, test questions, resources for further learning, and an implementation guide which includes a detailed outline of the modules. Several new materials were added in August 2006. Pocket cards and PDA applications summarizing key point-of-care information on child oral health, adult oral health, and dental emergencies are now available. Patient education posters suitable for exam or waiting room display may also be downloaded. There are now two additional PowerPoint modules. Module 5, Oral Health and the Pregnant Patient, was released in September 2006 and may now be downloaded. Module 6, Topical Fluoride Application, is expected in the Spring of 2007. In October 2006 all 5 PowerPoint modules were digitally reformatted to reduce file sizes by 80-90%. This will allow much faster downloads. (Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded)

Get the presentations here at the FMDRL web site

Wednesday, July 18, 2007

Treatment outcomes of dental injury diagnoses as related to blood flow measurements from teeth

Treatment outcomes of dental injury diagnoses as related to blood flow measurements from teeth
Journal of Oral Rehabilitation (OnlineEarly Articles).

Summary: The purpose of this study was to investigate whether dental injury diagnoses may predict adverse outcomes occurring 102 weeks after trauma, and to evaluate whether the severity of adverse outcome is related to laser Doppler flowmetry (LDF) measurements of blood flow from teeth. In 309 trauma patients, 404 permanent maxillary incisors and the respective contralateral homologous control teeth were investigated clinically and radiographically, and by LDF to assess local blood flow values. Dental displacement injuries were classified as grade I (subluxation), grade II (lateral or extrusive luxation), and grade III (avulsion or intrusive luxation). Dental fracture injuries were classified as uncomplicated crown fractures, complicated crown fractures, and root fracture. An adverse outcome was defined as the presence of ‘periapical radiolucency and/or grey discolouration’. Significant increase in risk of an adverse outcome occurred with a grade II dental displacement injury (15·07 odds ratio; P = 0·000), a grade III dental displacement injury (28·33 odds ratio; P = 0·000), and a root fracture (106·25 odds ratio; P = 0·000). Blood flow measurements that were significantly associated with more severe outcome were blood flow levels of ≤3 perfusion units (PU; 170·72 odds ratio; P = 0·000), and those of >3 PU and ≤6 PU (76·71 odds ratio; P = 0·000). Diagnoses of displaced and root fractured teeth predicted dental injury patients who went on to show adverse treatment outcomes of splinting. Blood flow measurements from teeth were related to the severity of adverse outcome.

Tuesday, July 17, 2007

Introducing Oral-B®'s latest innovation in power brushes, the new Triumph® with SmartGuide™. Oral-B Triumph with Smart Guide helps put your patients on their best brushing behavior.

New Oral-B Triumph with SmartGuide visibly guides patients to better brushing via a unique wireless display containing a pressure sensor alert and motivational timer that tracks brushing duration by quadrant.

* Patients who use Oral-B Triumph with SmartGuide are up to five times more likely to brush the recommended two minutes twice per day.*1
* According to a recent study, 93% of patients reduced their aggressive brushing behavior within 30 days.1

Try Oral-B Triumph with SmartGuide Professional Trial now for $39.95.

Oral-B Triumph with SmartGuide will be available to dispense in September, 2007.

Poor Dental Health May Raise Risk of Dementia

By Charles Bankhead
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.

* A review of data from an ongoing women's health study has identified a link between poor dental health and an increased risk of dementia.

* The data came from an observational study and not a randomized, controlled clinical trial and cannot prove causality.

* The findings were reported at a medical conference and in a published abstract and should be considered preliminary until they have been published in a peer-reviewed journal.

SAN ANTONIO, July 13 -- The fewer teeth someone has in middle age, the greater the risk seems to be for dementia later in life, data from an ongoing study of women's health suggest.

Poor dental health increased the likelihood of dementia by 30% to 40% over a 32-year period, regardless of cardiovascular status, according to a report at the International Society of Vascular Behavioral and Cognitive Disorders meeting here.

After adjustment for multiple demographic and clinical factors, the association between tooth count and dementia remained significant.

Previous studies have suggested an association between poor dental health and cardiovascular disease, possibly linked by the common thread of lower socioeconomic status. However, the two seemingly disparate health conditions also have some intriguing potential biological links, said Robert Stewart, M.D., of King's College London, England.

"Inflammation is a particularly interesting area," Dr. Stewart said. "Someone with poor dental health often has chronic infections in their teeth and gums. This gives rise to circulating inflammatory markers, and circulating inflammatory markers are potentially related to cardiovascular disease, dementia, and a host of other diseases that people are very interested in studying whether inflammatory pathways are involved."

To look at a dental health/dementia correlation, Dr. Stewart and colleagues analyzed data from the Women's Health Study of Goteborg, Sweden. The study includes women born in 1908, 1914, 1918, 1922, and 1930. The women had clinical examinations in 1968, 1974, 1980, 1992, and 2000. Dental exams took place in 1968, 1980, and 1992, and diagnostic evaluations for dementia were conducted in 2000.

Dr. Stewart and colleagues conducted a nested analysis of 638 surviving women who had dental exams in 1968 and dementia evaluations. The study group included 84 women who met criteria for dementia.

As compared with dementia-free participants, women with dementia were older (more than 90% were 78 or older), were less likely to have a high school education, and more likely to have a history of myocardial infarction.

Comparison of dental status and prevalence of dementia revealed a clear inverse association between tooth count and dementia in 1968, 1980, and 1992 (years when dental exams occurred). For example, about 25% of women with dementia had fewer than nine teeth at the 1968 dental exam, compared with a dementia prevalence of about 5% in women who had 25 or more teeth.

In an analysis adjusted only for age, declining tooth count was associated with an odds ratio of 1.3 for dementia. Adjustment for education and a variety of cardiovascular risk factors had minimal impact on the association. Adjustment for weight change between 1968 and 1992 resulted in an odds ratio of 1.4.

"Dental health is a prospective predictor of dementia which does not appear to be accounted for by cardiovascular comorbidity," Dr. Stewart concluded. "It may in part be a marker of cognitive reserve or education but inflammatory and nutritional causal pathways require investigation."

Future investigations will focus on finding other cohorts with data from dental and cognitive assessments, he added, but very few have been identified thus far.

Monday, July 16, 2007

Laser Used To Help Fight Root Canal Bacteria

High-tech dental lasers used mainly to prepare cavities for restoration now can help eliminate bacteria in root canals, according to research published in the July issue of The Journal of the American Dental Association (JADA).

The study, conducted by researchers in Austria, credits the development of miniaturized, flexible fiber tips for allowing the laser to be used in endodontic (root canal) treatment.

Dr. Ulrich Schoop and a team of researchers in the dental school at the University of Vienna used 60 extracted human teeth with one root each to test the effects of laser irradiation on root canals using an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser.

Dr. Schoop and colleagues inoculated the root canals with one of two types of bacteria (Enterococcus faecalis and Escherichia coli) and then irradiated the canals using either a 1- or 1.5-watt power setting.

The team found that the laser reduced the amount of E. coli at the lower power setting and reduced it to below the detection level at the higher setting. It also was effective in eliminating E. faecalis.

Researchers found, too, that the laser removed the smear layer and debris from the root canal walls and that the temperature rise during irradiation was within safe borders.

The authors concluded that the Er,Cr:YSGG laser may be suitable for cleaning and disinfecting root canals and that it can be used safely if the common precautions for using lasers are observed and the energy levels and irradiation times are within the proposed range. They also suggested that clinical studies are needed to confirm their laboratory findings.

In a related article in July JADA, Dr. Roy H. Stevens and colleagues at the Kornberg School of Dentistry, Temple University, describe their study of an Er,Cr:YSGG laser with a new tip that emits radiation radially.

Dr. Stevens and colleagues examined the efficiency of this new laser tip in disinfecting root canal dentin walls infected with E. faecalis. They found that it significantly reduced the amount of E. faecalis in contaminated root canals.

Sunday, July 15, 2007

American Dental Association And The Alaska Native Tribal Health Consortium Issue Joint Statement On Litigation Settlement

Just my opinion. So this is what happens when your side looses the law suit (ADA). Spin doctors and money at work.

The Alaska Native Tribal Health Consortium (ANTHC) and the American Dental Association (ADA) issued the following statement today:

"We are pleased to announce that the Alaska Native Tribal Health Consortium (ANTHC) and the American Dental Association (ADA) have agreed to settle our legal dispute. With this chapter behind us, we pledge to cooperatively advance our best efforts toward improving the oral health of Alaska Natives.

"This settlement is a starting point for a new era of cooperation between the dental profession and the ANTHC and its affiliated Tribal health organizations in exploring ways to improve access to dental care in rural Alaska. The issue that has divided us -- our difference of opinion concerning the scope of practice of dental health aide therapists -- will not deter our efforts to advocate for increased resources for dental care in rural Alaska.

Our cooperative efforts will include:

-- Developing dental residency programs to create a "pipeline" of dentists who could help alleviate the backlog of care in remote areas;

-- refining existing dental workforce models and developing new ones, including the ADA- developed community dental health coordinator (CDHC), to expand the availability of oral health education, prevention and treatment throughout the Alaska Native community;

-- coordinating the placement of volunteer dentists in Tribal communities;

-- and conducting an impartial, longitudinal study to determine the effectiveness of various workforce models, including the DHAT and CDHC, in improving access to oral health and oral health care in Tribal areas.

"In addition, both the ANTHC and the ADA pledge to continue our vigorous advocacy in Washington to ensure that Congress funds the Indian Health Service sufficiently to fill the excessive number of vacant dental positions in its dental programs.

"Finally, the ADA will contribute to the ANTHC Foundation to support efforts to promote preventive oral health in remote Alaska. ADA and ANTHC agree that prevention is the key to long-term success in improving oral health for Alaska Natives."

See previous blog post.

Friday, July 13, 2007

Are You A Bleach-A-Holic?

Dentists Trying To Urge Healthy -- Not Hollywood -- Standards

Video on Chicago NBC5 web site

CHICAGO -- Are you a "bleach-a-holic?" If so, you are in good company: dentists say the number of Americans over-using teeth-whitening products is on the upswing.

They want white, but some are getting something quite different.

"I had one patient say, 'You can never be too thin, too rich or have too white teeth.' I don't know about that," said dentist Alice Boghhosian.

Dentists are concerned about unrealistic expectations.
Click here to find out more!

Thursday, July 12, 2007

BIOLASE Comments on Market Activity

RVINE, CA--(Marketwire - July 10, 2007) - BIOLASE Technology, Inc. (NASDAQ: BLTI), the world's leading dental laser company, today stated that it is not aware of why there has been a significant stock price decline in recent trading sessions. President and CEO Jeffrey W. Jones said that the Company's operational results for the quarter just ended were on track and that management is looking forward to sharing its progress in detail when it announces those results.

BIOLASE currently plans to announce its results at 6:00 AM EDT on August 7, 2007 and to hold an investor conference call at 9:00 AM EDT that same morning. Instructions to access the call will be announced next week.

Wednesday, July 11, 2007

Sugary tea warning

Drinking lots of sugary tea can be almost as bad for your teeth as sipping fizzy drinks, the British Dental Health Foundation has warned.
Older people who might suffer from recurring decay are particularly at risk, said the dental charity, reacting to a report in the European Journal of Clinical Nutrition that claimed drinking tea can be even healthier than drinking water.
The BDHF agreed that tea can be good for oral and general health, but said many of these benefits will be reversed if people take sugar with their tea.
Dr Nigel Carter, chief executive of the Foundation, said: ‘It is absolutely true that tea can have a variety of oral and general health benefits.
‘It contains fluoride which strengthens tooth enamel and has been proven to reduce tooth decay, it has anti oxidants that clear your system and it re-hydrates you.
‘However, many people take sugar with their tea and this can cause tooth decay if consumed too frequently.
‘Tooth decay is a problem in Britain. It can be a particular problem for the elderly who might suffer from recurring decay where their teeth have been weakened by fillings.
‘In addition older people are often less health conscious. For people who drink six or seven cups of tea per day – each with two sugars – these drinking habits can be almost as bad as the constant sipping of fizzy drinks by young people.
‘With that in mind, we recommend that people who take sugar in their tea limit their tea drinks to mealtimes where possible. Milk and water are better between meals alternatives.’

Tuesday, July 10, 2007

Professor's discovery offers a lifetime of cavity protection

Working in his research lab in 1976, Dr. Jeffrey Hillman accidentally discovered a mutant strain of Streptococcus mutans, the bacteria that causes tooth decay. Unlike typical Streptococcus mutans, this strain was lactose-deficient, meaning that after it gorged on sugar, it didn’t produce copious amounts of lactose acid, the stuff that digs holes in tooth enamel.

Hillman, a dentist and professor of oral biology at the University of Florida’s College of Dentistry, immediately recognized the potential of this newfound strain: No more cavities. No more drills.

After years of clinical trials, first on rats and now on people, Hillman’s treatment is moving closer to market. Called Replacement Therapy, it essentially replaces the Streptococcus mutans already in the mouth with a modified, lactose-deficient strain. “It may take six months to a year, but eventually our strain will kick out the disease-causing strain,” he says. “A one-time treatment can give lifetime protection.”

Read the rest by clicking here

Monday, July 09, 2007

Un-Boxing Pentron's Artiste Composite

If you have not tried Pentron's Artiste nano composite you should. I have been using Pentron composites (Flow-It and Simile) for years. I have for the past few months been using some samples of the new Artiste nano composite and have been very happy with the results. I recently acquired
The F/X Kits consists of various opaque and bleaching shades along with various stains. There is even a Posterior Pit Stain.

The kit boxes are big but are nicely organized with two pull out trays.

There are quick start restorative guides that explain how to do the layering process with the composites.

A very comprehensive manual describing the techniques used to get outstanding results is also included. The basic idea is to select the base color of the tooth and place that composite. A top layer of the corresponding enamel color is then placed over the base cover giving a beautiful cosmetic effect.

Here is an example of Artiste. Click on the picture to enlarge the image.

The syringe Primary Palatte Kit is $839.95 and the F/X Kit is $589.95.

Pick up a few syringes or single dose shades and given them a try.
More information is available on the Pentron Web Site.

OxyCheck Pulse Ox: $199 on Finger Tip

OxyCheck obtains results in less than 10 seconds. OxyCheck reliably turns on with finger insertion and turns off with finger removal. No need to worry about draining the batteries due to failure to turn off. Works on pediatric to large adult fingers
8mm to 26mm (0.3-1.0 inch) thickness. Uses standard, inexpensive, easy to find AAA batteries. 18 hours of continuous use or 1600 spot-checks.

More information on OxyCheck is here

Sunday, July 08, 2007

Risk for the development of atherosclerosis in women with a high level of dental plaque and severe gingival inflammation

B. Söder, M. Yakob (2007)
International Journal of Dental Hygiene 5 (3), 133–138.

Introduction: Chronic infection and inflammation are considered to be risk factors in the development of cardiovascular diseases; the chronic inflammatory and microbial burden caused by the dental plaque in these individuals may predispose them to atherosclerotic process.

Aims: The aims were to study the involvement of a high level of dental plaque, severe gingival inflammation and periodontitis in the development of early atherosclerotic process in women.

Methods: Forty-six randomly chosen women with periodontitis and 21 periodontally healthy women were subjected to a comprehensive clinical oral examination, including oral hygiene status and level of gingival inflammation. Atherosclerotic risk factor analysis and carotid ultrasonography were performed. Common carotid artery intima-media thickness (IMT) and lumen diameter were measured and intima-media area (cIMA) was calculated. The following statistical methods were used: analysis of variance, chi-squared tests and multiple logistic regression analysis.

Results: There were highly significant differences between the patients and controls in the amount of dental plaque, gingival inflammation as well as bleeding on probing and pocket depth. The mean values of IMT and cIMA were significantly higher in women with periodontal disease than in controls. Multiple logistic regression analysis identified periodontitis as a principal-independent predictor of both the common carotid artery cIMA and IMT.

Conclusions: The present results indicate that a high amount of dental plaque, severe gingival inflammation as well as periodontitis seem to be associated with the development of atherosclerotic lesions in women already at its early and subclinical stages.

Saturday, July 07, 2007

The Biodegradable Source Toothbrush

If you love the environment and brushing your teeth, then the Source Toothbrush is for you.

Replaceable head toothbrush with renewable resource handle.
Wood Fiber blended with PLA, a plastic derived entirely from Nebraska maize. The resulting material is 100% renewal resource.
Flax with post consumer polypropylene.
Replaceable Heads consume 1/5 the material of standard toothbrushes.
Replaceable heads - reduces environmental impact.
Radial bristling - first toothbrush in the world to have it. Makes brushing easier and more effective.
3,080 Tynex® nylon bristles - available in soft or medium. Reversible for right or left hand.

Cost is $7.95

Friday, July 06, 2007

Measurement of stain on extracted teeth using spectrophotometry and digital image analysis

This could be interesting if a device can be manufactured to work in the mouth.

DL Lath, RN Smith, YH Guan, M Karmo, AH Brook (2007)
International Journal of Dental Hygiene 5 (3), 174–179.

Aim: The aim of this study was to assess the reliability and validate a customized image analysis system, designed for use within clinical trials of general dental hygiene and whitening products, for the measurement of stain levels on extracted teeth and to compare it with reflectance spectrophotometry.

Method: Twenty non-carious extracted teeth were soaked in an artificial saliva, brushed for 1 min using an electric toothbrush and a standard toothpaste, bleached using a 5.3% hydrogen peroxide solution and cycled for 6 h daily through a tea solution. CIE L* values were obtained after each treatment step using the customized image analysis system and a reflectance spectrophotometer. A statistical analysis was carried out in SPSS.

Results: Fleiss’ coefficient of reliability for intra-operator repeatability of the image analysis system and spectrophotometry was 0.996 and 0.946 respectively. CIE L* values were consistently higher using the image analysis compared with spectrophotometry, and t-tests for each treatment step showed significant differences (P < 0.05) for the two methods. Limits of agreement between the methods were −27.95 to +2.07, with a 95% confidence of the difference calculated as −14.26 to −11.84. The combined results for all treatment steps showed a significant difference between the methods for the CIE L* values (P < 0.05).

Conclusion: The image analysis system has proven to be a reliable method for assessment of changes in stain level on extracted teeth. The method has been validated against reflectance spectrophotometry. This method may be used for pilot in vitro studies/trials of oral hygiene and whitening products, before expensive in vivo tests are carried out.

Thursday, July 05, 2007

NHS 'dental crisis' in West

From the Belfast Telegraph

Monday, July 02, 2007

By Claire Regan

Private practice has squeezed NHS dental work to such an extent that there is no longer one providing the service in Fermanagh, an SDLP MLA said.

Assemblyman Tommy Gallagher said he was extremely concerned about the lack of availability of NHS dental treatment to patients right across Northern Ireland because of a growing emphasis among dentists on private practice.

The Fermanagh/South Tyrone MLA said people in his constituency, particularly the elderly, are having "great difficulty" finding an NHS dentist to treat them within the county or in an emergency.

"Some patients are having to travel outside the county, which is not an ideal situation if you're an elderly person who can't drive," said the Stormont health committee member.

"There isn't a dental practice in Fermanagh that doesn't have a large element of private practice. There is clearly a demand for private treatment and dentists are responding to that.

"The problem is that NHS patients are being squeezed out. This problem is not unique to Fermanagh."

He urged Health Minister Michael McGimpsey to deal urgently with the matter.

"In the short-term, we need dentists to be employed by the NHS to carry out work in each of the health board areas or in key locations of need, " he said.

"In the longer term, the Department of Health needs to be sorting out proper contracts with dentists so they can deliver NHS treatment in a different way to which it is now being done."

The politician said the importance of oral health to general health should not be underestimated.

He and his party colleague Carmel Hanna have tabled an Assembly motion on the issue.

Wednesday, July 04, 2007

Melatonin Shows Promise in the Fight Against Periodontal Diseases

From the APP web site

Melatonin could be the latest supplement to join the fight against periodontal diseases. According to a literature review in the June issue of the Journal of Periodontology, melatonin may promote bone formation and stimulate the body’s immune response, which are two factors that can affect a person’s periodontal health.

Since its discovery in 1917, melatonin has been found to be involved in many biological functions such as setting the body’s sleep rhythms and fighting off free radicals that may lead to cancer and other autoimmune diseases. The authors of this study conducted an extensive review of the literature (e.g., PubMed, Science Direct, Web of Knowledge, etc.) to evaluate the potential effects of melatonin on the oral cavity, including: melatonin as an antioxidant and free radical scavenger; melatonin as a host modulation agent; melatonin as a promoter of bone formation; and melatonin and periodontal disease. This review found strong evidence that melatonin may play a key role in periodontal health by helping to maintain bone levels in the oral cavity through suppressing the cells that work during bone resorption, and enhancing the body’s host response to the periodontal bacteria. One of the most devastating effects of periodontal disease is bone loss in the jaw which often leads to tooth loss.

“Although the review did not directly look at melatonin as a treatment option for periodontal diseases, this is an area that might be worth investigating in the future,” said review author Antonio Cutando, DDS. “Melatonin has important physiological functions that have not yet been explored in dentistry or in the treatment of periodontal diseases.”

Melatonin also has strong antioxidant and anti-inflammatory effects that help to improve the body’s immune response to infection. Recent studies have shown that salivary melatonin levels may actually vary according to the degree of periodontal disease, indicating that melatonin may act to protect the body from periodontal bacteria and inflammation.

“While natural supplements such as vitamin D, calcium, and vitamins E and C have been shown to have possible effects on periodontal diseases patients should be aware that supplements alone are not a substitute for periodontal care,” explained Preston D. Miller, DDS, and AAP president. “Patients should make an effort to know their pocket probing depths, which are the key to understanding their periodontal disease. A healthy probing depth of one to two millimeters with no bleeding represents a healthy mouth. Probing depths of three to four, that bleed, generally need more than a simple cleaning- they may require a procedure called scaling and root planing. When probing depths reach five millimeters or greater the patient has reached a level which may require surgical treatment to restore lost bone. Patients should keep this pocket size guide to their oral health in mind and should not hesitate to ask their dental professionals about their probing depths if this information is not volunteered.”

Tuesday, July 03, 2007

The World in a Glass: Wine may reduce cavities

By Jack Heeger
Friday, June 29, 2007

Have cavities and hate to go to the dentist? Maybe the answer is to drink wine.

According to WebMD, Italian researchers bought some red and white wine, then removed the alcohol to prevent it from interfering with the lab tests. They marinated cavity-causing bacteria in the wine, and both wines reacted against the bacteria. They said that red wine may have more antibacterial properties than white.

The study also indicated that wine may have a positive effect on a sore throat, as well.

(But WebMD cautions that the study was done in test tubes, so don’t cancel that dental appointment yet.)

Monday, July 02, 2007

Dental robot chews over a toothy problem

A robotic system that mimics the biting, chewing and munching of the human jaw is being developed by UK researchers. Called Dento-Munch, it should provide a more realistic way to test materials for use in dentistry, they say.

Some £2.5 billion is spent every year in the UK alone on dental materials, which are used to replace or strengthen teeth. But Kazem Alemzadeh, an engineer at Bristol University and the Bristol Robotics Laboratory, says the way these materials respond to everyday wear and tear can be hard to predict.

"Without this knowledge the likely long-term performance of the materials cannot be judged," Alemzadeh told New Scientist.

Lengthy clinical trials can show how these materials will fare, but are expensive and time-consuming to perform. Machines that act as surrogate mouths for "chew-testing" are cheaper and faster but, until now, they have been poor imitators of humans, says Alemzadeh.
Realistic movement

With colleagues, he is working on the first robot that can reproduce the full movement of the human jaw. Two platforms act as the upper and lower jaws, with the lower jaw capable of moving in 6 degrees of freedom. Just like the human jaw, it can move and rotate around each 3D axis: up and down, forwards and backwards, and left and right.

"Current laboratory simulators utilise only 2 degrees of freedom," says Alemzadeh, "and results from different simulators are often very different."

The software controlling the motors and gearboxes inside Dento-Munch are also designed to respond to loads in a similar way to muscle and tendon.

Furthermore, feedback loops in the control system slow the chewing when resistance is high, and speed it up when there is less resistance, to give a more realistic response. Data collected from people chewing will be used to calibrate the system.
Limited uses

John McCabe researches dental materials at Newcastle University, UK. He says that replicating the mechanical processes of chewing could improve testing, but that Dento-Munch may not be useful in all cases. For example, testing materials for suitability of use within a living mouth is best done using biological lab experiments.

He adds that "a perfect simulation will take months or years for each test, as in the mouth", and working out how to perform accelerated tests will be difficult.

However, Alemzadeh believes the system could even have non-dental spin-offs, for example helping use robots to rehabilitate injured ankles. "Chewing and ankle movement are similar motions," he says.

Sunday, July 01, 2007

Population-based analysis of link between IV bisphosphonates and inflammatory conditions or surgery of the jaw

Date Published 28/06/2007
Reporter initials Yuet
Reporter surname Wan
Reporter affiliation Hospital Pharmacist
Source J Nat Cancer Inst published early online June 27, 2007

Abstract This American administrative claims based analysis examined the link between osteonecrosis of the jaw or facial bones and treatment with IV bisphosphonates. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) programme linked to Medicare claims for 16,073 cancer patients treated with pamidronate and/or zoledronic acid. They were matched to 28,698 bisphosphonate non-users and to 14,349 bisphosphonate users on month and year of the first bisphosphonate administration, cancer type, age, sex, risk factors for osteonecrosis (diabetes, alcoholism, cigarette smoking, obesity, hyperlipidaemia, pancreatitis, or chemotherapy with L-asparaginase), bone metastasis, and SEER programme geographical region. Patients were followed until the study's end, loss of coverage from Medicare, or one of the following outcomes: diagnosis of inflammatory conditions or osteomyelitis of the jaw, surgery on the facial bones, or death, whichever occurred first.

Compared with non-use, use of IV bisphosphonates was associated with an increased risk of:

• Jaw or facial bone surgery (hazard ratio [HR] = 3.15, 95% CI, 1.86 to 5.32)
• Diagnosis of inflammatory conditions or osteomyelitis of the jaw (11.48; 6.49 to 20.33).

In addition, the absolute risk at 6 years for any jaw toxicity was 5.48 events per 100 patients using IV bisphosphonates vs 0.30 events per 100 patients not using such drugs. Furthermore, the risk of each outcome increased as cumulative dose increased (e.g, for 4–8 infusions, HR for operations on the jaw and facial bones = 3.63; 0.77 to 17.08; and for more than 21 infusions, 9.18; 1.74 to 48.53).

The study concluded “users of IV bisphosphonates had an increased risk of inflammatory conditions, osteomyelitis, and surgical procedures of the jaw and facial bones. The increased risk may reflect an increased risk for osteonecrosis of the jaw.”

An accompanying editorial notes some of the shortcomings of the study:

• It is unclear what percentage of inflammatory conditions of the jaw actually represents osteonecrosis.
• Cancer patients on chemotherapy may experience exacerbation of, or new odontogenic infections as a result of, neutropenia and immunosuppression.
• A review of the medical records of the patients identified with inflammatory conditions of the jaw was not carried out to validate the presence of osteonecrosis.
• Risk of detection bias as clinicians are likely to have assessed patients on bisphosphonates more closely for jaw osteonecrosis than those not on treatment, due to increasing awareness of this potential oral complication.
• There may have been underreporting of jaw conditions consistent with osteonecrosis of the jaws since the first cases of bisphosphonate-related osteonecrosis of the jaws were reported in 2003, and the study ended in 2003. Since then, there has been a large rise in the number of cases reported due to increased awareness among oncologists and the dental community.

In spite of these shortcomings, the editorial acknowledges that this study does add to the growing body of evidence of the link between use of IV bisphosphonates and jaw osteonecrosis. Though the association had been called into question, it suggests that the sheer number of cases reported, as well as the mode of action of these drugs, lend support to the view that there is a real and probable causal relationship. It notes that studies are under way to define patient risk factors, identify biomarkers and radiographic findings that may predict osteonecrosis of the jaw. It concludes “the morbidity of skeletal-related events in patients with cancer compared with the morbidity of patients who develop osteonecrosis of the jaws (of various severities) must be carefully weighed before making decisions to continue or discontinue bisphosphonate use.”